Slaton, Malcolm Walton
Slaton, Malcolm Walton is an individual health care provider with primary practice located at 1014 Primrose Ave , Longmont CO 80301. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Slaton, Malcolm Walton can be contacted via phone (303) 704-6504.Contact Information
Primary practice address
1014 Primrose Ave
Longmont CO 80301
Phone: (303) 704-6504
Fax: (720) 652-4774
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 919 | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 919 | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 521 | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 103150 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 212 | Illinois |
Profile Details
| NPI number | 1730174897 |
|---|---|
| LBN Legal business name | Slaton, Malcolm Walton |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Sep 6th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730174897 | NPPES |
| Illinois | Other | 212 | STATE LICENSE |
| Illinois | Other | 521 | STATE LICENSE |
| Illinois | MEDICAID | 87986710 | STATE LICENSE |
| Illinois | Other | 103150 | STATE LICENSE |
| Illinois | Other | 919 | STATE LICENSE |
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